Background
Methods
Patients
Radiotherapy
Evaluation
Results
All patients | Responder (n = 29) | Non-responder (n = 13) |
P value | |
---|---|---|---|---|
Age (years) | ||||
≥ 65 | 21 (50%) | 14 (48.3%) | 7 (53.8%) | 0.739 |
< 65 | 21 (50%) | 15 (51.7%) | 6 (46.2%) | |
Gender | 0.187 | |||
Male | 26 (61.9%) | 20 (69%) | 6 (46.2%) | |
Female | 16 (38.1%) | 9 (31%) | 7 (53.8%) | |
Clinical metastatic stage | 0.079 | |||
cM0 | 7 (16.7%) | 7 (24.1%) | 0 (0%) | |
cM1 | 35 (83.3%) | 22 (75.9%) | 13 (100%) | |
ECOG performance status | 0.217 | |||
1 | 11 (26.2%) | 10 (34.5%) | 1 (7.7%) | |
2 | 23 (54.8%) | 14 (48.3%) | 9 (69.2%) | |
3 | 8 (19%) | 5 (17.2%) | 3 (23.1%) | |
Pathology | 0.695 | |||
Adenocarcinoma | 33 (78.6%) | 22 (75.9%) | 11 (84.6%) | |
Others | 9 (21.4%) | 7 (24.1%) | 2 (15.4%) | |
Differentiation | 1.0 | |||
Well differentiated | 1 (2.4%) | 1 (3.4%) | 0 (0%) | |
Moderately differentiated | 17 (40.5%) | 12 (41.4%) | 5 (38.5%) | |
Poorly differentiated | 18 (42.9%) | 11 (37.9%) | 7 (53.8%) | |
unknown | 6 (14.3%) | 5 (17.2%) | 1 (7.7%) | |
Borrmann type | 0.357 | |||
1 | 1 (2.4%) | 1 (3.4%) | 0 (0%) | |
2 | 2 (4.8%) | 2 (6.9%) | 0 (0%) | |
3 | 34 (81%) | 23 (79.3%) | 11 (84.6%) | |
unknown | 6 (14.3%) | 3 (10.3%) | 2 (15.4%) | |
Site | 0.381 | |||
Upper | 10 (23.8%) | 9 (31%) | 1 (7.7%) | |
Mid | 19 (45.2%) | 11 (37.9%) | 8 (61.5%) | |
Lower | 13 (31%) | 9 (31%) | 4 (30.8%) | |
Previous Treatment | 0.626 | |||
Surgery | 1 (2.4%) | 0 (0%) | 1 (7.7%) | |
Chemotherapy | 29 (69%) | 22 (75.9%) | 7 (53.8%) | |
Surgery +Chemotherapy | 2 (4.8%) | 1 (3.4%) | 1 (7.7%) | |
none | 10 (23.8%) | 4 (30.8%) | ||
Previous bleeding management | 0.398 | |||
No | 34 (81%) | 22 (75.9%) | 12 (92.3%) | |
Yes | 8 (19%) | 7 (24.1%) | 1 (7.7%) | |
Concurrent chemoradiotherapy | 0.079 | |||
No | 35 (83.3%) | 22 (75.9%) | 13 (100%) | |
Yes | 7 (16.7%) | 7 (24.1%) | 0 (0%) | |
Radiotherapy technique | 1.000 | |||
2-dimensional | 15 (35.7%) | 10 (34.5%) | 5 (38.5%) | |
3-dimensional | 27 (64.3%) | 19 (65.5%) | 8 (61.5%) | |
Radiotherapy filed | 0.495 | |||
Whole stomach | 13 (31%) | 8 (27.6%) | 5 (38.5%) | |
Partial stomach | 29 (69%) | 21 (72.4)% | 8 (61.5%) | |
Total radiation dose (Gy) | 39.6 (14–50) | 40 (18–50) | 21 (14–40) | <0.001 |
Total radiation dose BED10
a (Gy) | 46.7 (16.8–60) | 48 (21.6–60) | 26.4 (16.8–46.7) | <0.001 |
Discussion
Study | No | Prescribed dose | Symptom response rate | Relation RT dose and treatment outcome | Association between concurrent chemoradiotherapy and treatment outcome | ||
---|---|---|---|---|---|---|---|
Significant dose (BEDa) | Symptom response | Re-bleeding | |||||
Hashimoto et al. [10] | 19 | 40 Gy/16fx (range,2–50 Gy/1.8–3 Gy per fx) | 68.4% | 50 Gy10
| Yes (P = 0.040) | NR b
| NR b
|
Asakura et al. [7] | 30 | 30 Gy/10 fx (90% of patients) | 73% | 39 Gy10
| NR b
| NR b
| Decreased re-bleeding event (60% vs. 17.5%, P = 0.001) |
Lee et al. [17] | 23 | 30 Gy/10fx (range, 30-44Gy/10-22fx) | 91% | NR b
| NR b
| NR b
| NR b, g
|
Kim et al. [11] | 20 c
| 35 Gy/14 fx c (m/c) | 70% c
| 41 Gy10 d
| NR d
| Yes d (P = 0.05) | A trend towards better OS d
(6- month OS 50% vs. 23%, P = 0.08) |
Tey et al. [8] | 103 e
| 30 Gy/10fx (m/c) 8-Gy/1fx-40Gy/16fx | 80.6% e
| 39 Gy10 e, f
| No e (P = 0.78) | No e (P = 0.78) | NR b, g
|
Chaw et al. [16] | 44 | 8 Gy/fx (75%) or 20 Gy/5fx (25%) | 50% | 14.4 or 28 Gy10
| No (P = 0.202) | NR b
| NR b, g
|
Present study | 42 | 39.6 Gy/20fx (range, 14–50.4 Gy/7-28fx) | 69% | 36 Gy10
| Yes (P < 0.001) | No (P = 0.238) | A trend towards better symptom response rate (24.1% vs. 0%, P = 0.079) |